Subtherapeutic Doses of Vancomycin Synergize with Bacteriophages for Treatment of Experimental Methicillin-Resistant Staphylococcus aureus Infective Endocarditis.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_A083F3FD86C1
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Subtherapeutic Doses of Vancomycin Synergize with Bacteriophages for Treatment of Experimental Methicillin-Resistant Staphylococcus aureus Infective Endocarditis.
Journal
Viruses
Author(s)
Save J., Que Y.A., Entenza J., Resch G.
ISSN
1999-4915 (Electronic)
ISSN-L
1999-4915
Publication state
Published
Issued date
16/08/2022
Peer-reviewed
Oui
Volume
14
Number
8
Pages
1792
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
Background. Recurrent therapeutic failures reported for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infective endocarditis (IE) with vancomycin may be due to poor bactericidal activity. Alternative antibacterial approaches using bacteriophages may overcome this limitation. Objectives. An experimental rat model of MRSA IE (EE) was used to examine the efficacy of vancomycin combined with a 1:1 bacteriophage (phage) cocktail composed of Herelleviridae vB_SauH_2002 and Routreeviridae 66. Methods. Six hours after inoculation with ca. 5 log <sub>10</sub> colony forming units (CFU) of MRSA strain AW7, animals were treated with either: (i) saline, (ii) an equimolar two-phage cocktail (bolus of 1 mL followed by a 0.3 mL/h continuous infusion of 10 log <sub>10</sub> plaque forming units (PFU)/mL phage suspension), (iii) vancomycin (at a dose mimicking the kinetics in humans of 0.5 g b.i.d.), or (iv) a combination of both. Bacterial loads in vegetations, and phage loads in vegetations, liver, kidney, spleen, and blood, were measured outcomes. Results. Phage cocktail alone was unable to control the growth of strain AW7 in cardiac vegetations. However, when combined with subtherapeutic doses of vancomycin, a statistically significant decrease of ∆4.05 ± 0.94 log <sub>10</sub> CFU/g at 24 h compared to placebo was detected (p &lt; 0.001). The administration of vancomycin was found to significantly impact on the local concentrations of phages in the vegetations and in the organs examined. Conclusions. Lytic bacteriophages as an adjunct treatment to the standard of care antibiotics could potentially improve the management of MRSA IE. Further studies are needed to investigate the impact of antibiotics on phage replication in vivo.
Keywords
Animals, Anti-Bacterial Agents/pharmacology, Anti-Bacterial Agents/therapeutic use, Bacteriophages, Endocarditis/drug therapy, Endocarditis, Bacterial/drug therapy, Endocarditis, Bacterial/microbiology, Methicillin-Resistant Staphylococcus aureus, Microbial Sensitivity Tests, Rats, Staphylococcal Infections/drug therapy, Staphylococcal Infections/microbiology, Vancomycin/pharmacology, Vancomycin/therapeutic use, MRSA, bacteriophage, infective endocarditis, phage therapy, vancomycin
Pubmed
Web of science
Open Access
Yes
Create date
06/09/2022 11:27
Last modification date
23/01/2024 8:31
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